Three months ago I had a crown done. I’ve been back every week since then trying to get it adjusted because it’s hurt from the beginning. Today, though, it broke off and a piece of it shattered off. I’ve gotten to the point where I don’t trust the dentist who did the crown, so I decided to try an emergency dentist. The great thing was they got me in that day. I just wanted them to re-bond it on. I didn’t even care about the chunk that broke off because the tooth isn’t visible. But, the emergency dentist refused. He insists the crown has to be entirely replaced. Is he just doing this because it’s someone else’s crown?

Pamela W.

Dear Pamela,

I don’t know the dentist, so I definitely couldn’t tell you his motive. What I can tell you is something is seriously wrong with that crown and it is more likely that it actually does need replacing. Even if the broken piece isn’t visible, it is broken. You’ll have rough, possibly even jagged, edges that can cut you. More than likely, there’s a tiny opening somewhere that material can get into the crown. That will lead to decay and then instead of needing a new crown, you’ll need a tooth extraction and dental implant to replace the tooth.

A porcelain crown should last a minimum of five years. Yours didn’t even make it half a year. The first thing you can do is go back to the original dentist and have him replace the crown free of charge. That’s a perfectly reasonable demand because your crown is not functional. I understand that you don’t trust the dentist who did the crown. So that may not be an option you’re too keen on.

Aside from having him do another crown, you have two choices. The first is just pay the emergency dentist to create a new crown for you. Crowns aren’t a difficult, advanced procedure. Every general dentist knows how to do one (Well, maybe except your dentist). If the tooth were visible, you would need to make sure the dentist was an artistic cosmetic dentist. But, you said the tooth isn’t visible so just a decently attractive functional crown will be fine.

If paying for a second crown is a hardship, you are within your rights to ask your dentist for a refund on the dysfunctional crown he provided. Even if it’s not a hardship to pay for the second crown, you should ask for a refund out of principle. If he doesn’t do even minimally adequate work he needs to be held accountable.

I know it’s been a frustrating experience for you but hopefully, a properly made crown will take some of this stress away. I’m certain you’ll at least feel better physically.

I’ve had a lifetime of problems with my teeth. Two days ago I went to my dentist and told him I just want him to remove all my teeth and for him to make me dentures. He told me it was a horrible idea and at my age, my face would collapse. I’m just so discouraged. Can you explain to me why it would make my face collapse?

Stacey A.

Getting Dental Implants Will Prevent Facial Collapse

I understand how frustrating it can be to have teeth which constantly cause problems. But, let me assure you no matter how many problems your natural teeth are giving you, it will still be better than what you’ll face with dentures.

What your dentist referred to is facial collapse. It’s a term dentists use to describe what happens after so many years of wearing dentures. Once your teeth are removed, recognizing you no longer have roots to support for your teeth, your body begins to reabsorb the minerals in your jawbone to use where they’re needed most. At some point, you’ve lost so much jaw bone that your face takes on a collapsed appearance, as you can see in the photo above.

They have many other drawbacks too. Even the best fitting dentures reduce your chewing capacity by 50%. Plus they’re not anchored, which allows them to slip and slide, and even fall out. Fortunately, there are alternatives.

Your first step will be to save as many teeth as can be saved. Some may just need crowns to protect them. If you get porcelain crowns, a skilled dentist can make them look absolutely beautiful. Of course, you may have teeth which can’t be saved. In that case, I’d highly recommend dental implants. As you can see from the image above, a prosthetic root is implanted into your jawbone, then a dental crown is placed above it. They’re totally secure, look natural, and are like having your own natural (but healthy) teeth back.

One of the biggest benefits of dental implants is the fact that they will prevent facial collapse. Even though your teeth were removed, because you have the prosthetic roots your body leaves the minerals there to help support the dental implant. It’s a much better option.